Individual
THEODORE E YAEGER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1620 MASON AVE STE E, DAYTONA BEACH, FL 32117-5513
(386) 506-5115
Mailing address
1620 MASON AVE STE E, DAYTONA BEACH, FL 32117-5513
(386) 506-5115
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
2006-00936
NC
2085R0001X
Radiation Oncology Physician
Primary
ME43556
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5906556
—
NC
Enumeration date
04/10/2006
Last updated
07/17/2026
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